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对五只患有肺动脉狭窄的犬以及一只患有肺动脉狭窄和冠状动脉异常的犬使用心电图门控计算机断层扫描、超声心动图和选择性血管造影。

Use of ECG-gated computed tomography, echocardiography and selective angiography in five dogs with pulmonic stenosis and one dog with pulmonic stenosis and aberrant coronary arteries.

作者信息

Laborda-Vidal P, Pedro B, Baker M, Gelzer A R, Dukes-McEwan J, Maddox T W

机构信息

University of Liverpool School of Veterinary Science, Leahurst, Chester High Road, Neston, CH64 7TE, UK.

University of Liverpool School of Veterinary Science, Leahurst, Chester High Road, Neston, CH64 7TE, UK.

出版信息

J Vet Cardiol. 2016 Dec;18(4):418-426. doi: 10.1016/j.jvc.2016.08.003. Epub 2016 Sep 29.

Abstract

Pulmonic stenosis (PS) is the most common congenital cardiac disease in dogs. Boxers and English bulldogs are among the most commonly affected breeds and also commonly associated with an aberrant coronary artery (CA). If an aberrant CA is suspected and balloon valvuloplasty indicated, an intra-operative angiography is recommended prior to the procedure. ECG-gated computed tomography (CT) can be used to screen for CA anomalies in a quick and minimally-invasive way (preventing side effects associated with selective catheter angiography) and allowing early planning of the procedure. The aim of this case series was to report CT findings associated with PS diagnosed by echocardiography. Our database was retrospectively searched for cases of dogs with PS diagnosed by echocardiography, where an ECG-gated CT was performed. A total of six cases were retrieved: all were diagnosed with severe PS. Four dogs had concurrent congenital defects: two dogs had a patent ductus arteriosus, one dog had a ventricular septal defect and an overriding aorta, one dog had an aberrant CA. Detailed CT findings of all cases were reported, including one case of a patent ductus arteriosus and an overriding aorta not identified by transthoracic echocardiography. In addition, an abnormal single left coronary ostium, with a pre-pulmonic right CA was described. In conclusion, despite echocardiography remaining the gold standard for diagnosis and assessment of PS, ECG-gated-CT angiography is a complementary diagnostic method that may provide additional relevant information, shorten surgery/anaesthesia time and reduce the amount of radiation to which the clinician is subjected.

摘要

肺动脉狭窄(PS)是犬类最常见的先天性心脏病。拳师犬和英国斗牛犬是最常受影响的品种,并且通常还与冠状动脉异常(CA)有关。如果怀疑有冠状动脉异常且需要进行球囊瓣膜成形术,建议在手术前进行术中血管造影。心电图门控计算机断层扫描(CT)可用于快速、微创地筛查冠状动脉异常(避免与选择性导管血管造影相关的副作用),并有助于早期制定手术计划。本病例系列的目的是报告与经超声心动图诊断的PS相关的CT检查结果。我们对数据库进行了回顾性检索,以查找经超声心动图诊断为PS且进行了心电图门控CT检查的犬类病例。共检索到6例:均被诊断为重度PS。4只犬同时存在先天性缺陷:2只犬有动脉导管未闭,1只犬有室间隔缺损和主动脉骑跨,1只犬有冠状动脉异常。报告了所有病例的详细CT检查结果,包括1例经胸超声心动图未发现的动脉导管未闭和主动脉骑跨病例。此外,还描述了一种异常的单一左冠状动脉开口,伴有肺动脉前右冠状动脉。总之,尽管超声心动图仍然是PS诊断和评估的金标准,但心电图门控CT血管造影是一种补充诊断方法,可能会提供额外的相关信息,缩短手术/麻醉时间,并减少临床医生所受的辐射量。

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